Journal
EUROPEAN JOURNAL OF NUTRITION
Volume 53, Issue 2, Pages 557-566Publisher
SPRINGER HEIDELBERG
DOI: 10.1007/s00394-013-0564-0
Keywords
Dietary patterns; Breast cancer; Argentina; Multilevel; Sensitivity analysis
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Funding
- National Scientific and Technical Research Council (CONICET)
- National University of Cordoba
- National Science and Technology Agency
- FONCyT [PICT 2008-1814, PICT-O 2005-36035]
- Science and Technical Secretariat of the University of Cordoba (SECyT-UNC) [05/H207]
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Several studies have shown the effect of dietary patterns on breast cancer risk, but none has been conducted in Argentina. The aim of this study was to extract dietary patterns from Food Frequency Questioner, to estimate their effect on breast cancer occurrence while taking into account aggregation factors (family history of breast cancer) and to explore the sensitivity of the estimates to changes in the assumptions. A principal component exploratory factor analysis was applied to identify dietary patterns, which were then included as covariates in a multilevel logistic regression. Family history of BC was considered as a clustering variable. A multiple probabilistic sensitivity analysis was also performed. The study included 100 cases and 294 controls. Four dietary patterns were identified. Traditional (fat meats, bakery products, and vegetable oil and mayonnaise) (OR III tertile vs I 3.13, 95 % CI 2.58-3.78), Rural (processed meat) (OR III tertile vs I 2.02, 95 % CI 1.21-3.37) and Starchy (refined grains) (OR III tertile vs I 1.82, 95 % CI 1.18-2.79) dietary patterns were positively associated with BC risk, whereas the Prudent pattern (fruit and non-starchy vegetables) (OR III tertile vs I 0.56, 95 % CI 0.41-0.77) showed a protective effect. For Traditional pattern, the median bias-adjusted ORs (3.52) were higher than the conventional (2.76). While the Prudent pattern was associated with a reduced risk of BC, Traditional, Rural and Starchy patterns showed a promoting effect. Despite the threats to validity, the nature of associations was not strongly affected.
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